The Multi-purpose Arthritis Center at Dartmouth has developed physician and allied health professional staff sufficient to develop and execute more than 40 separate projects during the 01-03 years. We propose, in the 04-06 years, to emphasize several broad objectives: (1) to develop programs which, by virtue of cost-savings to health care buyers, will be self-supporting; (2) to develop educational programs in the community which emphasize the team approach for physicians and allied health personnel; and (3) to provide education at the graduate level for allied health professionals. Educational needs for primary care physicians determined during 01-03 pilot studies will be met by large scale programs involving record audits and programmed education to match needs of specific physician groups. Networks of physicians and AHP's particularly interested in rheumatology will be developed and used as a catalyst for implementation of community projects. The goal of our patient education program developed in 01 to 03 years will be to determine cost effectiveness, with a goal of having it accepted by third party payers. Core units for sports medicine and AHP/physician/patient education are presented. Scientific research in the laboratory on mechanisms of destruction of joints in rheumatoid arthritis and on the pathophysiology of crystal-induced inflammation remain as crucial components of academic life in the MAC. Clinical research will be highlighted by a double-blind feasibility study to test the effectiveness of methotrexate in severe refractory rheumatoid arthritis and by a registry of patients with hemochromatosis. We plan to develop resources in Maine to use our educational programs for professionals and patients, and to support educational objectives of the Maine arthritis professionals.